How To Know When You Need Physical Therapy Postpartum + How It Works

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I had the awkward privilege of going through physical therapy postpartum for “down there” after my first baby. I was not happy about it, but it was totally necessary. Not many mamas head to physical therapy after baby, and I think many more should if they can afford it, or have the insurance to cover it. Physical therapists, especially those who specialize in postnatal care, can help tremendously. Knowing whether you need physical therapy can be hard to decide, and sometimes you have to express to your doctor that you believe you need it, otherwise it will never be mentioned.

For me, I knew something wasn’t right after my 6-week check up. I was given the thumbs up, but I was totally scared. I felt like everything had closed all the way up…and I felt nauseous just thinking about it.

Without going into too much detail, I wasn’t romping around in the bedroom after the 6-week mark. Completely the opposite, and I literally felt like I was sewn together too tight.

It took two more trips to the doc to get checked out again, and told I just needed some anxiety medicine, which DID NOT HELP. Something wasn’t right. Finally, my doctor suggested I go to physical therapy, one who specializes in postpartum care.

Here’s where you know you need physical therapy:

When your gut tells you something isn’t right. This is obvious, but many women ignore their gut the most. It is better to be reassured that everything is okay 20 times, than ignore a feeling.

When time goes by, and you think everything should be healed, but it isn’t. With a normal recovery, you will be uncomfortable, but over time, you will start feeling more comfortable again and adjusting to your new body. If this doesn’t happen months after delivery, like 9-12 months later, you might want to consider seeing a physical therapist.

If you look pregnant, a year after birth. You muscles may need extra training and work beyond a program like mine to encourage them to repair and find strength again.

You can always see a physical therapist if you are unsure, and they can tell you how they can help you. It doesn’t hurt to go in for one consultation to ease fears, or gain reassurance that your body is doing what it is supposed to.

Once you decide you need a physical therapist, here is what the process looked like for me:

I wasn’t sure what I was going to be walking into, but I was very hopeful to find some relief. The first step was to describe the pain and uncomfortable feelings I was experiencing. From there, the physical therapist went into checking my pelvic floor muscles. This required no panties, and a tool that was able to monitor how I contracted my pelvic floor muscles, as well as relaxing them.

It turned out I was activating my muscles well, but not relaxing them. The tool was placed on the outer area where your pelvic floor muscles surround your vagina. It helped to see a reaction on her screen when I contracted and relaxed to gain better control of my muscles.

From that point, she examined me, and found that there was scar tissue where I had stitches, causing things to feel totally weird and painful. She used a numbing cream and an ultrasonic machine to massage and help break up the scar tissue. She told me that the scar tissue was going to need to be worked out, and loosened. The scar tissue is our body’s natural, hard tissue to prevent an injury from tearing again.

I went back for 6 weeks, or 6 appointments, and slowly things got better. The scar tissue got loosened enough, to wear I could function again normally. Two pregnancies later and three births total, I am completely recovered.

Not everyone needs physical therapy, or professional help, but all postpartum mamas should embark in some kind of healing program to help guide them on how to take care of their bodies. I had a much better postpartum experience with my third baby because I was in better shape when I had him, and I took way more time to strengthen and heal my body! I can’t express how important this is, and it deserves attention and investment.

About

Katie is Pre/Post Natal Exercise Specialist, and a mom of three boys very close in age. She's experienced many of the not-so-fun aspects of postpartum recovery. She is also highly educated in physical therapy (worked as a PT aid for 2 years and studied in school), Pilates (completed the BASI instructor course and taught for 1 year), and nutrition.